2017 ACKNOWLEDGMENT WAIVER & RELEASE FROM LIABILITY FORM (AWRLF) FOR THE TRANSAMERICA CHICAGO TRIATHLON OPEN WATER SWIM CLINICS Read this form carefully. Once you have read this form, if you agree to all the terms and conditions contained in this from click the I AGREE button at the bottom of this page and proceed with registration. If you are under 18 years in age, a Parent or Guardian is required to input their name and click the (I AGREE) button for you to continue with registration for this event. I certify that I have carefully read and understand all the 'Confirmation information' contained on the TRANSAMERICA CHICAGO TRIATHLON OPEN WATER SWIM CLINICS (Event) web site. I further certify that as the participant, I am physically fit and have sufficiently trained to participate in the either the CHI that my child is physically fit and has sufficiently trained to participate and that my physical condition for participation or my child's physical condition for his or her participation has been verified by a qualified licensed medical Doctor (MD). I also acknowledge that the swim portion of the Event my child or I will be participating in will be an extreme test of my or my child's abilities and carries the potential for death or injury. I also acknowledge that as the participant in the swim leg of that Event, I or my child must be capable of safely swimming a distance equal to or greater than the swim distance in the Event, and that if I or my child are participating in the TRANSAMERICA CHICAGO TRIATHLON OPEN WATER SWIM CLINICS, as the participant, one of the following is true: a) I have participated on an age group, high school or college swim team. b) I have completed the swim in a triathlon of equal or greater distance. c) I have completed a continuous swim in a pool or in open water of equal or greater distance within the last 30-days. I also certify that the equipment I or my child will be using in the Event including but not limited to a wetsuit, bike helmet, bicycle, etc., fit properly, have been verified by a qualified professional to be in good working order, and at a minimum meet the standards as outlined on the Event web site under Rules of Participation/Race Day Procedures. I acknowledge that the Event will be an extreme test of my or my child's physical & mental ability & carries the potential for death, serious injury & property loss. Risks include, but are not limited to those caused by terrain; road surface; temperature; water conditions; contact with obstacles or water craft; weather; vehicular traffic; actions of others and lack of hydration. I am aware that the support personnel who will provide emergency first aid will be volunteers. I hereby consent to receive medical treatment for myself or my child that may be deemed advisable in the event of injury, accident or illness during the event(s). I hereby take action for executors, my administrators, heirs, next of kin, successor, assigns and myself as follows: A. WAIVE, RELEASE & DISCHARGE from any and all liability for myself or my child, for my or my child's death, disability, personal injury, property damage, property theft or actions of any kind which may hereafter accrue to me or my child as a result of my or my child's participation in the TRANSAMERICA CHICAGO TRIATHLON OPEN WATER SWIM CLINICS THE FOLLOWING PERSONS OR ENTITIES: Life Time Fitness, Inc (Life Time Fitness) the producer of the Chicago Triathlon, SuperSprint and The Kids Triathlon; all Event Sponsors; race directors; race staff and crew; race volunteers; the City of Chicago, the Chicago Park District, Cook County, the State of Illinois, and its (their) office, officers, directors, employees, representatives & agents & volunteers. B. INDEMNIFY & HOLD HARMLESS the above mentioned persons or entities contained in this AWRLF from any & all liabilities and expenses (including reasonable attorneys' fees) or claims made by other individuals or entities as a result of any of my or my child's actions during the TRANSAMERICA CHICAGO TRIATHLON OPEN WATER SWIM CLINICS. I understand that during the clinic,I or my child may be photographed and I agree to allow my or my child's photo, video, name or likeness to be used for any legitimate purpose by Life Time Events and all other Event Sponsors and/or assigns without compensation to me or my child. This form shall be construed broadly to provide a release and waiver to the maximum document; and I understand its contents. I am aware that the Event TRANSAMERICA CHICAGO TRIATHLON OPEN WATER SWIM CLINICS, is an advertising/marketing vehicle for Events Sponsors (SPONSORS) and that SPONSORS merely provide trade (product and/or services) and/or financial support. I am also aware that SPONSORS have no part in, or responsibility for, planning, conducting or administering any aspect of the Event or for the well being, health or safety of Event participants. I hereby agree that in the event of race cancellation due to weather conditions, 'acts of God,' or any other reason, my or my child's Event registration fee shall not be refunded

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The purpose of this organization is to provide for the surviving spouses and dependents of law enforcement officers, firefighters and paramedics who lose their lives in the line of duty. This includes federal, state, county and local officers, firefighters and paramedics stationed in both Cook and Lake Counties.Through both public donations and private fundraising efforts, the program plans to generate more than $25,000 in direct contributions to the 100 Club of Chicago during the 2017 season.

What is the longest triathlon you have completed, if any?

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If other, which events?

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Are you currently registered for the 2017 Transamerica Chicago Triathlon?